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The Pathophysiologic Significance of Structural Abnormalities

Nancy C. Andreasen, MD, PhD; James C. Ehrhardt, PhD; Victor W. Swayze II, MD; Randall Jay Alliger, PhD; William T. C. Yuh, MD, MS EE; Gregg Cohen, MS; Steven Ziebell

Arch Gen Psychiatry. 1990;47(1):35-44.

Abstract
• In a second large series of schizophrenic patients studied with magnetic resonance imaging at the University of Iowa, Iowa City, earlier findings of decreased frontal, cerebral, and cranial size were not replicated. In this second series, control subjects were selected to be educationally equivalent to the schizophrenic patients, a modification in design that may partially account for the failure to replicate. By means of coronal images, ventricular volume was compared in patients and controls and found to differ to a highly significant degree, with the frontal horns being possibly slightly more enlarged than the rest of the ventricular system. A prominent sex effect was also observed, with most of the increased ventricular size occurring in the male patients. Within the male patients, the thalamus was also observed to be significantly smaller, a finding that could be consistent with periventricular injury. Patients with prominent negative symptoms had significantly larger ventricular size than did those with the mixed or positive subtypes. Because of its superior resolution, magnetic resonance imaging appears to offer a more sensitive index of ventricular enlargement than that provided by computed tomography.

Author Affiliations
From the Department of Psychiatry, University of Iowa College of Medicine (Drs Andreasen, Swayze, and Alliger and Messrs Cohen and Ziebell), and the Department of Radiology, University of Iowa Hospitals and Clinics (Drs Ehrhardt and Yuh), Iowa City.

Footnotes
Accepted for publication March 8, 1989.

Reprint requests to Department of Psychiatry, University of Iowa College of Medicine, 500 Newton Rd, Iowa City, IA 52242 (Dr Andreasen).

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